90 days after Congress passed the health care legislation, California counties want 2014 to come in a hurry.

Ninety days have passed since Congress approved health care
legislation. Many of the key policies, however, won't go into
effect until 2014.

The White House is calling that gap a "bridge period," but some
county officials make it sound more like they are clinging to a
life raft in stormy waters en route to Health Care Island.

Declining tax revenues mean almost every county, from Alameda to
Yolo, have cut back on indigent health care services---whether it's
senior home care or doctors visits for the children of undocumented
workers. Take---Yolo. County assistant administrator Pat
Leary---she says she's waiting for the federal aid that will come
to help cover low income residents in 2014.

"Not just to hand off the baton and wash our hands of it, and say
thank goodness that's no longer our problem, [but also the aid]
that will help transition the county into compliance with the
federal law," Leary says.

Many California counties, like Yolo, are asking for Federal money
to figure out how to transition their local health programs in
advance of 2014.

Immediate Changes

There have been some immediate changes to health care law, for
example, prescription drugs are cheaper for seniors, young adults
can stay on their parents health plan, and the federal government
is offering grants to states to investigate insurance rate
increases.

Insurance Commissioner Steve Poizner is also scrutinizing health
insurance rate increases with more vigor, say policy advocates like
Dev Gnanadev. The former California Medical Association President,
Gnanadev says more changes need to be made to the law---including
more expansive prescription drug coverage.

"I don't think we should take this [as] this is the Ten
Commandments, gospel from God. It is just the beginning. We got a
long way to go," Gnanadev says.

There are more changes scheduled for September---including
guaranteed coverage for children with pre existing conditions.
Counties in California will also be able to apply for grants that
will help them ready their health department for major policy
changes scheduled for 2014.